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General NPI Number Information
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NPI Number | 1568865962
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Entity Type | Organization
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Legal Business Name | ZIA A DEHQANZADA MD APC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 2 MEDICAL PLAZA DR #275
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City | ROSEVILLE
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State | CA
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Zip | 95661-3043
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Country | US
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Telephone | 916-797-7534
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MEDICAL PLAZA DR #275
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City | ROSEVILLE
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State | CA
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Zip | 95661-3043
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Country | US
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Telephone | 916-797-7534
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ZIA AHMAD DEHQANZADA
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Credential | M.D.
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Telephone | 916-932-4675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | A118745
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License Number State | CA
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